I hate it when one of my patients falls over on the ward. Each time this happens, I feel as if I, somehow have personally failed to keep them safe, safe, when they are unwell and at their most vulnerable.

It is true, that people falling in hospital is complex, it is equally true that we can do lots to reduce the likelihood of falling – close observation, avoiding dehydration, proper footwear (special grippy red stocking slippers if no shoes in Doncaster), eating and sleeping well, treating infections, monitoring for postural hypotension – when an individual’s blood pressure drops when they stand-up (the opposite is meant to happen), reviewing medicines, and on and on.

Many of the people who fall on my ward shouldn’t be in hospital – they aren’t actually ill. Although I still refer to them as patients, for they are under my ‘care’ and are experiencing the…

“Trust is like the air we breathe. When it’s present, nobody really notices. But when it’s absent, everybody notices.” Warren Buffett

You are a new #MedEd dean charged with modernizing and integrating a postgraduate education program into a recently merged health care delivery system. The new organizational structure is built on past structures that emphasize authority/accountability and resources/responsibilities gaps. How do you navigate this environment? How do you build the necessary trust networks to accelerate change?

Most health care and educational systems have organizational charts that describe formal structures and lines of authority. However, much of the work done in any system is influenced by informal “advice”, trust, and communication networks that operate independent of the “org chart”. An essential skill of a #MedEd leader is to build an effective trust network.